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HomeMy WebLinkAbout030-2027-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600358 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 3070048 Permit Holder's Name: City Village Township Parcel Tax No: John Eral TOWN OF SAINT JOSEPH 030-2027-20-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ! O 1 GS 22.30.20.439E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ~,J CAPACI STATION BS ~HI,~ FS ELLErV. A. (P Septic r 'rte ~ZSO Benchmark Z .7(. 16Z.-7 '11100 Z '11100 Dosing O~ 2 7~o Alt. BM P i/• e/av r Z Bldg. Sewer 4.0 Holding St/Ht Inlet 7,40 95" r TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. ent t Air Intake ROAD Dt Inlet a+ Septic Dt Bottom Z4 Milli '011, 7 Dosing ' . Header/Man. Aeration Dist. Pipe -/t Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Z • Manufacturer Demand St ver Ot~~ S GPM Model Number ~c 3~• 6 0 5~~ ~r S~ TDH Li I I Fricti os System HQad~ TDH . F Forcemain Length/ Dia It I Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Tches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION ^ CHAMBER OR Type tem: + J UNIT Model Number: i_ DISTRIBUTION SYSTEM I oil Headerr/Ma Distributiow, / Ix Hole Size X Hole Spacing V Air Inta Pipe(s) C/[ Length Dia 2. Length Dia " Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only w Depth Over Depth Over xx Depth of y Jxx Seeded/Sodded jxx Mulched Bed/Trench Center 1.(07 Bed/Trench Edges Topsoil ' ~.4.- o~yp~ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 6 27 g Inspection #2: h Location: 1444 TRIANGL~QR I` ~O C)~ T 1.) Alt BM Description = • P/Q'j vet 2.) Bldg sewer length 3Z - amount of cover = it GOJQz' Plan revision Required? ❑ Yes *No 2 ' $ I Use other side for additional information. J J _1 Date 71nnsepctor"s ature Cert. No. SBD-6710 (R.3/97) County Safety and Buildings Division St. Croix 201 W. Washing1t~ Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, I 53707-7162 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 3a d6 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m). Stats. 1. Application Information - Please Print All Information Same Property Owner's Name Parcel # J. Michael Homes, Inc. - John Eral 030-2027-20-000 Property Owner's Mailing Address Property Location 2097 Co. Rd. D, Suite A Govt. Lot _3 a City, State Zip Code Phone Number 4. '4, Section _22 y (circle one) Joe 4 Maplewood, MN 55109 (651)808-3966 T_30 _N; R_20 EorW II. Type of Building (check all that apply) Lot # ® I or 2 Family Dwelling - Number of Bedrooms 4 Subdivision Name 01d Na L._ ❑ Public/Commercial - Describe Use Na ❑ City of ❑ State Owned - Deslbe Use CSM Number ❑ Village of Co X 160 46✓ Na ®Town of St. Joseph Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. D - ~ ❑ New System ® Replacement System ❑ Treatment/Flolding Tank Replacement Only ❑ Other Modification to Existing System Tlam) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner /7 1 IV. T e of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade , ®Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) _ ❑ Pretreatment Device (explain) _4 f V. Dispersal/Treatment Area Information: PolyLok PL-525 effluent filter Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed 'l 1.0 gpd/sq.ft. ASTMC-33sand (0 ~lev 2" ~ 600.00 G d 98.75' a 12" above p 0.6 gpd/sq.ft. native soil 1,0001 0 sq. ft. 1,369.68 Sq. Ft./ 97.75' contour VI. ank Info Capacity in Total # of Manufacturer Gallons Gallons Units v New Tanks Existing "tanks i C ~y ` N ai v, o ~ r ~ ca d a U ~ ~ w c7 a. Septic or Holding Tank 1,250 0 1,250 1 Wies r Concrete }t Dosing Chamber 750 0 750 1 Combination ST/PC X VIL Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number William Schumaker MP 227990 (715) 386-2131 Plumber's Address (Street, City, state, Zip Code) 1070 Scott Road, Hudson, WI 54016 Vlll. Count /Department Use Only ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature $ x; ❑ Owner Given Reason for Denial tit IX. Condi( vr0w.Reasons for Disapproval S'Mlk" irk, Eftvn: like- tai 64ierr_'!i C0 Must all be s~t_fc~?S ' ±;,E ,ni g4 \ C 4 as per inar.ayement plan pro iae-± uv plu,nbe!. J 1 2. Al tse4tasrk rrxtlwst: en s tnt t Lti r {.rt ir' Ed I r ' ( ~ 7` \ ~I Y I JI II I im PerWknbla cWlo / ti:rdimxtf- V Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 z I I inches in size ) SBD-6398 (R. 11/11) L CJ1. l~~% ( J al'`, r>♦ ~~~~yvr ~;l~ l Q~'~`ZYS ftflK Cam, cJI. ~ T34i R.sa~.,T.~sE.Jesepl~, 8< TPA/y~.. s~. 66 LA) r. gctlraq.$ee~`P• a t /e Pe% FE o30 -zozr .2o- cbo UCorAC~ ,gsSu.rrc~(elt✓ = !x r~ ev acre-,5 ioo.c~: (838.~''[t.s 6.se%~~ Cas6;ronr/or+~~.;ocS..c•rf~ SEE C01'PEa I'tGi ly j ~r~~' I V ~Y L~.'7CS a ' d%s~ae.-sue. c~tl. E lp % C8j'f 0W.S.C.S) r(..75 ' - i 61 970 A 977-S' I% Forrtax a r^ ~ ~.1 j d ~ i o , . ~ 1 f Goe.~xs•~ ~'l~or e !ec!` ' Ea be = 94(7s f ~ n ! -l ~ Propos~.d Ab ~ ~ v/,g,/yLO,t~P~-szs r ~ b~drr~n ~ ~ ~ ~ Ga ' f. Tocc~E,~LL~. 5r ` ~ 6fi NlCC ` << _ .o rf ✓,e; ;.,~o~e~~+e~----- Pro ~ 1 311 ,tI ~ ~ 9~~s'' ~ be ~5doneo! o \ f ,r i ~ 5 F~.~oescd wcI' ~ \433 1, 1 ~ 3s4i.2o' 9l~sq io be PfOPOSed 4a'G'x~w'~:s/~crsrc/ee/%T..,o d,•f6-I~or, {cic/ ~ ~ /i>_""•r 9B. s'o'w/ y a!';~'ce.s ,~ccd 9~TS''af /s Q6dvQ 97.75' "A ~iri~ia q well v 4r ~ .1 d r ~.t1E ~ ~r Q st .,19 I J. Michael Homes, Iz c. - Residential Mound POWTS Index Title S4~eet Project Name: J. Micael Homes, Inc, 4 bedroom Residential Mound Owners Name: John Eral Owner's adress: 2097 Co. Rd. D, Suite A, Maplewood, MN 55109 Site address: 1444 Triangle Dr., Houlton WI 55082 Project Location: Subdivision: Na Legal Description: Gov't. Lot 3, Sec. 22, T.30N., R.20W., Town of St. Joseph, St. Croix Co., WI. Parcel ID 030-2027-20-000 Page I Index and Title Sheet Page 2 State Approved Mound Design Page 3 Septic/Pump Tank Cross Section Page 4 Effluent Filter Cross Section Page 5 Septic Tank Maintenance Agreement Page 6 Map of Survey Page 7 Warranty Deed Mater Plumber: Bill Schumaker, DSPS Credential #227990 Signature: L-L!"._---Date: Page I of 7 Design pursuant to In-Ground Soil Absorption Component Manual for POW FS, version 2.0 SBD-10705-P (N.01/01 R.10/12) /.iyp 1arNF~\ • ~~V'\ DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN P $ HOLMEN WI 54636-9466 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary March 05, 2018 CUST ID No. 227990 ATTN. POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016-7302 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/05/2020 SITE: Identification Numbers J Michael Homes Inc Transaction ID No. 3070048 1444 Triangle Dr Site ID No. 847062 Town of Saint Joseph Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. Gov't. lot 3, S22, T30N, R20W FOR: Description: Four Bedroom Mound System \ Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1750291 Maintenance required; Replacement system; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. a No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. f, The following conditions shall be met during construction or installation and prior to occupancy or use: QFE ,x l.o10 Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be mad th the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The existing POWTS shall be abandoned per SPS 383.33, Wis. Adm. Code. • A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. . f • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 a.m. - 4:00 p.m. jerry.swim@wi.gov cc: James K Thompson , Ace Soil & Site Evaluations Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are resnonsihip fnr the installatinn nnPratinn nr maintPnanr,P ofthP PnWT~',, Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Tf~@ Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 a.m. - 4:00 p.m. jerry.swim@wi.gov cc: James K Thompson, Ace Soil & Site Evaluations Edwin A Taylor, Wastewater Specialist. (71 634-3484, Mon-f-L 8:00 A.M. - 4:30 P.M. D Z vXi 66" AS 86" m REQD 53" z Z c fr*t n nx Q m a 3" I 57" 6" D I m I 48" I I 1 I o I m° m I > I I I I r I N r N I I I. V I I ~ m I_ c m °I z -u u o r 0 51 m D N I D N m 0 D C DQ D r r Z Z r v X Dv c m m i > m C 0RNr xX vZ ° y °NZ> z 5arm-vZm>oc)> zC co 0 U) ~ VI0 m o m N D m0~ x =v~~=v2SAOrZ N N ~D Nm n ;J Z° m~° arv- °Z G~W ~ co c: 'n NC=~-1C mZOD rTlq~ N U7 MO ZZ \ v m Z cn?m °D ma' 6n m.. O D N D N S N I ~ rn v~ f- N ~ \ p X ° =n ° °v U)mD I m °.p.v.p° 0 > in p Nz Z m (n0-n Dr ~0!c'! Ov~ D n ° c 0 G7 rrm^ m r riD ca ~ o n O z o v OH Z nv c7 D om- nr'D Dp m D I rri Z A Z- = r -u A m m Dv Z~1 O v O C7 U) O o D r D C N r 0 z rri 0 -V Fl Jo U) V1 m m . =:f ..;c z 0 m r- ;o 2 D D H v r c m r m r FA F m m ;v 0 U \ = W1250/750-MR m MIERER CINCIETE DRAWN BY. " ' I SCALE. PRE-POUR: °m+ SEPTIC MANUAL REV. \ zz W3716 US HWY 10 MAIDEN ROCK, N 54750 DATE: 00/00/00 DATE POST-POUR: 800-325-8456 FlIF Pj- 3 0-~'7 v!~'L: 52 EF'EL DENT FILTER C X - .1i1"B~LLCHECk - - EXCEP e' SND 4, .1 F:;R IN _QHN➢,xH ,1,y I 1t~ ~ Ia.3E "I '.E ELSHIf EE,aPT j 131, 4~ a SI, 4C 3.' 7 5 23 r r P'_-525 Fr_T_F ~OLSII,G PART NC Q-525 MA ERIA r OUSING - POL "PROPY_Eti : j ~U-LElBUSMNG - PVC c 5 DALE - riGPc xcfvrsc o;rsA r:~ g jL f r Ea'.S 1'571:0 98 fOk HIrDLE.XTENr1Jt, a 79, 04 dhJKEGSH ROJTS _ OFE~ NIVG ~I S a k x ~ ~ 1 E I A fi I 15G2 9 } t rJL`LGK FL-525 FI 1FF CaR ~LGE - ~ ~ F ART NO - 30141.52. ~I N.AIERi?i-PGLYPROPY_EVE 1 L MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application ---B 2 7 Z018 INDEX AND TITLE PAGE C ES Project Name: J. Michael Homes, Inc. Owner's Name: John Eral Owner's Address: Property Address: 1444 Triangle Dr., Houlton, WI 55082 Legal Description: Gov't. Lot 3, Sec. 22, T.30N., R.20W. Township: St. Joseph County: St. Croix Subdivision Name: Na )ITIONALLY ROVED Lot Number: Na Block Number: Na SAFETY AND Parcel I.D. Number: 030-2027-20-000 ryNAL SERVICES `JSTRY SERV Plan Transaction No.: Page 1 Index and title " - Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil evaluation report Designer: Bill Schumaker License Number: 227990 Date: 02/14/18 Phone Number: (715) 386-3121 Signature:. Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 L Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 600.00 Design Flow (gpd) 2.00 Site Slope 97.75 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. E~ 0.125 Orifice Diameter (in) 2.40 Estimated Orifice Spacing (ft) = 7.14 ftz/orifice 2.00 Forcemain Diameter (in) 200.00 Forcemain Length (ft) Does the forcemain drain back? 87.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 32.62 Forcemain Drainback (gal) 11.25 Vertical Lift (ft) 90.29 5x Void Volume (gal) 4 jD:: /7-5.05 Friction Loss (ft) 122.91 Minimum Dose Volume (gal) h 0.00 In-line Filter Loss (ft) 34.60 System Demand (gpm) V t 22.80 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection ~a in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 773.76 Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) 48.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 16.12 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 773.36 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 16.12 Dose Tank Volume (gal/in) PL-525 Filter Model Number Wieser Concrete Manufacturer Project: J. Michael Homes, Inc. Page 2 of 9 Mound Plan and Cross Section Views T 1/106: J Observation Pipe - K r ~r r fr i rr. ~ r r .r f r t r r r, r~r 5 1 A W - B I L Mound Component Dimensions A 6.00 ft E 13.44 in H 1.00 ft K 8.56 ft B 100.00 ft F 9.50 in T ft L ft D 12.00 in G 0.50 ft J W 600.00 (ft2) Dispersal Cell Area 1369.68 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.54 (ft) .r//11//lf //flffff., j f//!1/f Z /f//fIf11//111. G 111!llfl/f!!//!//l11f1 lf///11/,.. 98.75 (ft) Dispersal Cell 99.25 (ft) Lateral Invert Dispersal Cell: Elevation D Q.. G xr) i46 ry _ { k. . ...max. „ 97.75 (ft) Contour Elevation 2.0 % Site Slope Geotextile Fabric Cover Shading Key ~ a Dispersal Cell See lateral details on 1❑ Topsoil Cap o C 1.5 ft ti Page 4 for number, size, 0 Subsoil Cap w o //1!1//i and spacing of laterals. ©0 ASTM C33 Sand Laterals are equally F spaced from the TvPica~ ~aterai ~s Tilled Layer d 0.5 ft distribution cell's f f x.Y• f 2' Aggregate v ox~x centerline in the A distribution cell (AxB). Project: J. Michael Homes, Inc. Page 3 of 9 End Connection Lateral Layout Diagram L 1111 ~1 i 11 01 ~ a r e. t'r si t a, Turn-up vaVbsll vs1v# <x ealawn*uIplug AN fatarals sr# t4whocal 14- x - ~ Dotal draw'! 00 tier t ttom. tht tstteai aJ4 spared or main nlw eWn too r„W crass t m of ~*'a, Later,Als & for r n Sch 40 PVC per SP 3 T e 384.3i7-615 Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.40 ft Lateral Length (P) 98.40 ft Orifices per Lateral 42 Lateral Spacing (S) 3.00 ft Orifice Density 7.14 ft2/orifice Lateral Flow Rate 17.30 gpm Manifold Length 3.00 ft System Flow Rate 34.60 gpm Manifold Diameter 1.50 in Total Dynamic Head 22.80 ft Forcemain Velocity 3.53 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - SPS 316.300 WAC 4 in. min. Disconnect ---!ll--- Tank component is properly vented F- Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in Capacity 773.36 Gallons T Volume 16.12 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 26.35 424.77 B 2.00 32.24 C Pump off elevation (ft) C 7.62 122.91 ~ 88.00 D 12.00 193.44 Total 47.98 773.36 D Dose tank elevation (ft) 3" Bedding un er tank. 87.00 Alarm Manuafacturer SJ Rhombus Note: Switches Alarm Model Number SJE 1011421 containing mercury _ may not be used in Pump Manufacturer Goulds this system. Pump Model Number EP05 Pump Must Deliver 34.60 gpm at 22.80 ft T D H Project: J. Michael Homes, Inc. Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone (715) 386-2131 POWTS Regulator's Name L St. Croix County Zoning Dep't. Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • X:545 Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Sweep 90 or Two Degree Bends Same Diameter as Lateral Project: J. Michael Homes, Inc. Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 gip], G0ULDS PUFFS Submersible a - Effluent Puri cpJ4 EPOS 38 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- 0 Bearings: Upper and Icv,ei grade turbine oil for tic enclosed design for heavy duty ball bearing S;aecJi~ally designed for the lubrication and efficient improved performance. construction. fcilo,.ving uses: heat transfer. • Eftli ?nt. systems 0 Casing and Base: Rugged • Hcn es Available for automatic and thermoplastic design provides AGENCY LISTING _ • Farms superior strength and corrosion manual operation. Auto SP Canadian standardsAssocia.iofi • Hea,,y duty sump matic models include resistance. • Water transfer Mechanical Float Switch s Motor Housing: Cast iron for efficient heat transfer, Goulds Pumps is ISO 9001 Registe ea • Dewatering assembled and preset at the factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. maximum. ■ EP04 Impeller: Thermoplas- a Power Cable: Severe duty • Capccities: up to 60 GPl tic Semi-open design with rated oil and water resistant. • Iota' heads: up to 3'1 feet. pump out vanes for mechanical • Disc' 1-,rge, size: 1'/-" NPT. seal protection. • Mec` anlcai seal carbon- rotai /;ceramic-stationary, EUNA-N eiastomers. • Teinocrature: 104 1- (40°C) coi 140 (60°C) Intermittent METERS FEET • aAci,ers. 300 Series stair ess steel r 9 30' SGFha • ca x.ble of running dry viithout damage to a -z.s Fr coinvonen+s. ,T zs Q i"Vlotor: z II • EP0z; Single phase: 0.4 HP, U 61 zo 115 230 V, 60 Hz, 1550 a RPV ;wilt in overload with 5 auto ratic reset. 15 1 a 4~ • EP0` Single phase: 0.5 HP, o EPOS 117 l cr 230V, 60 Hz, 1550 3 r 10! i RPM ouiit in overload with EP04 automatic reset. z • Powei cord: 10 foot STandard length, 16/3 1 SJTCFJ with three prong grounding plug. 1 20 0- 00 10 2'0 30 ao so 6Pi;I root ength, 16/3 SJT`,h with three prong grounding plug 2 4 _ 0 2 4 6 10 12 m3h star~~dard on EP05j. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIIIP CERTIFICATION FORM Owner/Buver J. Michael Homes, Inc. - John Eral 1\1aiIIng Address 2097 Co. Rd. D, Suite A, Maplewood,MN, 55109 Property Address 1444 Triangle Dr., Houlton, WI 55082 (Verification required from Planning & Zoning Department for new co ruction.) City/State Parcel Identification Number 030-2027-20-000 LEGAL DESCRIPTION Gov't , lot 3 , . 22 30 20 St. Joseph Property Location , Sec. , I' N R W, Town of Subdivision Plat: Na . Lot # Na Certified Survey Map # Na . Volume Na Page i* Na Warranty Deed # ~ 1005437 (before 2007)V olume Na . Page 4 Na Spec house ❑yes0no Lot lines identifiable Byesnno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and tree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department ofNatural Resources, State of Wisconsin. Certification stating that your septic system ~nas been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days ~)f the th -e year expiration date. 1/we certify that all statements on this for re tru to I e best of my/odVknowledge. I/We am/are the owner(s) of the property described above, by virtue of a warr 11iAd rec Register of Deeds Office. 4 r , Nuzzxooms SIGNAT URE OF APPLICANT(S) DA'hI: ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reterence is made in the warranty deed. (REV, 04/12) i Wisconsin Department of Safety and Professional Services Page 1 of 3 Division of Industry Services SOIL EVALUATION REPORT M C 4~ 0 ~ %01~ In accordance with SPS 38 Wis. Code County Attach complete site plan on paperpot less than 8 1/2 x 11 in m s Pla f e St. Croix but not limited to: vertical and horizontal reference point (BM), cti A Parcel I. scale or dimensions, north arrow, and location and distance' Q8 2~ A 030-20 0-000 Ref #2498 Please print all in pE40JBGE Revi d by Date 3 G / " Personal information you provide may be used for secc-a purposes Privac Law, s. 15.04 1 m . 1611 Property Owner Property Location J. Michael Homes, Inc. - John Eral Govt. Lot 3, NE '/a SW '/4 22 T N R 20 E (or) W 1 Property Owner's Mailing Address Lot # Block # Subd. ame or CSM# 1444 Triangle Dr. (Site Address) Na Na Na City State Zip Code Phone Number ❑ City ❑ village ® Town Nearest Road / T7 Houlton ( WI 55082 (651) 808-3966 St. Joseph Triangle Dr. 00 r , ® New Construction Use: ® Residential/ Numberof bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial Drift Flood Plan elevation if applicable na ft. t4 General comments and recommendations: Site suitab for mound P S plac d on 7.75' contour with 12' of ASTM-C33 sand lift. O,s ora ~l er O F 01e-- I 1 I Boring # ❑ Boring ® Pit Ground surface elev. 97.83 ft. Depth to limiting factor 28" in. 1 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-11 10yr3/3 none I 2fgr mvfr cw 2fm 0.6 0.8 2 11-20 10yr4/6 none I 2fsbk mvfr gw 2fm 0.6 0.8 3 20-28 10yr4/6 none 1 1 msbk mvfr cw 1 fm 0.4 0.6 4 28-45 10yr8/3 none LSBR Om na 1f 0.0 0.0 frag. - - i I I 2 Boring # ❑ Boring ® Pit Ground surface elev. 97.41 ft. Depth to limiting factor 24" in. Soil Application Rate I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#21 1 0-9 10yr3/3 none I 2fgr mvfr cw 2fm1c 0.6 0.8 2 9-18 10yr4/6 none I 2fsbk mfr cw 2fm1c 0.6 0.8 l 3 18-24 10yr4/6 none Ifs Osg ml cw 1f 0.5 1.0 4 24-38 10yr8/3 none frSBR Om na 1f 0.0 0.0 J Effluent #1 = BOD, > 30<- 220 m L and TSS > 30 150 mg/L Effluent #2 = BOD, > 30:5 220 m /L and TSS > 30<- 150 m /L CST Name Please Print Si nature ( ) g CST Number James K. Thompson L--- 30021 Address ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 January 29, 2018 (715) 248-7767 SBD-8330 (R04/1 s? 1 [:3] Boring Boring # U ®pit Ground surface elev. 97.74 ft. Depth to limiting factor 27" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/FtZ In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10yr3/3 none I 2fgr mvfr cw 2fm1c 0.6 0.8 2 11-20 10yr4/6 none I 2fsbk mvfr cw 1fm 0.6 0.8 3 20-27 10yr4/6 none I 1fsbk mvfr cw 1f 0.4 0.6 frag. 4 27-41 10yr8/3 none LSBR Om na 1f 0.0 0.0 4 Boring # F-1 Boring ®pit Ground surface elev. 96.68 ft. Depth to limiting factorX in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none I 2fgr mvfr cw 2fm1c 0.6 0.8 2 9-16 10yr3/6 none I 2fsbk mvfr cw 2fm1c 0.6 0.8 _a frag. 3 16-28 10yr8/3 none LSBR Om na 1vf,f 0.0 0.0 I Boring # ❑ Boring III---111 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I -1 Effluent #1 = BOD, > 30<_ 220 mg/L and TSS > 30 150 mg/L * Effluent #2 = BOD, > 30:5 220 mg/L and TSS > 30<_ 150 mg/L II'L lee ScQ/e.~ / tho' tP~~`zys J ecAae/W-ies,-'a. Corgi. 4d3 R Zoe., T. e{ .Sst~~ y ~ o e.-a rx u5 qnl✓aai (/~•FJt n t /e E P c% # o3e -.tox1'^1o - 000 CarAGr; Assu.+uc✓e[t~= ~ be r~ ~ G-Cre~S ioo.cts. 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